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More Bad News for Ambien (Zolpidem)?

by Dr. Sharon Orrange on February 28, 2014 at 12:22 pm

Zolpidem is the generic version of Ambien, which is also available in a longer acting form known as Ambien CR. These sleep medications (zolpidem, Sonata, Lunesta) are widely popular and known for their lack of hangover effect the next morning. These “atypical” benzodiazepines are different from “typical” benzodiazepines like Ativan, Xanax, or Valium in that they are used to treat insomnia but not anxiety.

Weird things can happen to people who take them, especially if you take one and continue to walk around and do things in your house. Now there is more concerning information that emergency department (ED) visits for adverse reactions related to zolpidem increased by 220% in a recent 5-year period. That’s important.

Scared or not? Know these things about zolpidem:

  • Talk to your doctor about other medications you are taking with the zolpidem.
  • Think of this medication as a short term solution and try alternative strategies for treating insomnia: avoiding caffeine, exercising regularly, sleeping in quiet darkened surroundings, and limiting TV and computers at night, which are stimulating.
  • In 2010, 13,180 zolpidem-related emergency department visits involved adverse reactions among women, which was more than double that for men.
  • The FDA recommends we halve the recommended dose for women. Zolpidem comes in 5 and 10 mg doses, and an extended-release version comes in 6.25 and 12.5 mg doses. For women the 5 mg dose is recommended because women metabolize the drug differently than men and 8 hours after taking the drug women still have higher levels of zolpidem in their system. The elderly should also take half of the recommended dose.
  • Almost half of the ED visits occurred when folks were taking zolpidem combined with other medications. People got in to trouble when mixing zolpidem with narcotics, other anti-anxiety medications, or alcohol.
  • The bad reactions that brought people to the ED were daytime drowsiness, dizziness, hallucinations, bizarre behavior, and sleepwalking.

Think of zolpidem as a short-term solution to insomnia, don’t take it with alcohol or other medications, and think about taking the lowest doses possible.

Dr O.

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